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This information is about sunitinib, which is also known as Sutent®. It may be used to treat people with a type of kidney cancer| called renal cell carcinoma (RCC) and a rare type of cancer called gastrointestinal stromal tumours (GIST)|. Sunitinib may be used to treat other types of cancer| as part of a research trial|.
Sunitinib is a type of drug called a multikinase inhibitor. It interferes with the growth of cancer cells. It also works by slowing the growth of new blood vessels within the tumour.
Sunitinib is licensed to treat people with kidney cancer (renal cell carcinoma). It's also licensed for people with gastrointestinal stromal tumours (GIST) that are no longer helped by the drug imatinib (Glivec®)|.
The National Institute for Health and Clinical Excellence (NICE|) is an independent body that currently gives advice on which new drugs or treatments should be available on the NHS.
NICE have recommended sunitinib as a possible first drug treatment for some people with advanced and/or metastatic renal cell carcinoma.
NICE has also recommended sunitinib as a possible treatment for people with gastrointestinal stromal tumours. If it's spread or can't be removed with an operation, or if you've already had imatinib treatment but it hasn't worked or wasn't suitable, you may be able to have sunitinib.
Sunitinib is also being studied as a possible treatment for other cancers, including melanoma|, bladder cancer|, breast cancer|, non-small cell lung cancer| and mesothelioma|.
Multikinase inhibitors work by interfering with proteins called kinases. Kinases are important in regulating how cells work and grow. They send signals to the cell that tell it to divide and make new cells. Kinase inhibitors block these signals and affect the cancer’s ability to grow.
Some types of kinases stimulate cells to make new blood vessels. Making blood vessels is called angiogenesis. Cancer cells need to make new blood vessels so that they can grow and spread.
In kidney cancer, higher than normal amounts of a type of kinase called vascular endothelial growth factor (VEGF) are made. VEGF stimulates the production of blood vessels, which helps the cancer to grow. Sunitinib blocks the activity of VEGF.
Sunitinib is an orange or caramel-coloured capsule. It comes in four strengths: 50mg, 37.5mg, 25mg and 12.5mg.
Sunitinib is taken with a glass of water. It can be taken with or without food. Your doctor will tell you what dose of sunitinib you'll need to take. The usual dose is one 50mg tablet a day. A cycle of treatment is one tablet a day for four weeks followed by two weeks off. Your doctor may adjust the dose. Sometimes sunitinib is given at a dose of 37.5mg daily, which you would take continuously.
Each person's reaction to cancer treatment is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone having this treatment.
As sunitinib is still a new drug, it's too early to know everything about the possible side effects. Check with your doctor if any side effects continue or are troublesome.
It's important to allow yourself plenty of time to rest.
You may notice redness of the palms of your hands and soles of your feet. Sometimes the hands and feet become sore or swollen. There may also be changes in sensation, such as numbness or tingling. If you notice symptoms, let your specialist know. Keeping your hands and feet cool, avoiding hot water and using a non-perfumed moisturiser may help.
Occasionally, if soreness doesn’t settle or if blistering develops, your doctors may need to reduce the dose of sunitinib or interrupt the treatment. Very rarely, treatment may need to be stopped.
Your mouth may become sore|, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush, can help. Some people find their mouth becomes too sensitive for regular mint toothpaste. If this happens, try a mild children’s toothpaste. Avoid salty or spicy food, which may sting your mouth.
Tell your nurse or doctor if you have mouth problems. They can advise you of
how best to take care of your mouth and prescribe any medicines you may need.
Hair and skin colour can be affected by sunitinib. Your hair may lose colour or become thinner. Hair thinning is temporary. Your skin may lose colour and become yellow in tone. Other changes to the skin may include a rash, redness, dryness or itching. Speak to your doctor or nurse if you have any of these symptoms.
Sunitinib can cause high blood pressure in some people. This is most likely to happen within the first few weeks of taking sunitinib. If you develop high blood pressure, your treatment may be interrupted or you may be prescribed medicine to control your blood pressure.
You may have frequent or loose bowel movements. Tell your doctor if these are severe or if they continue. It's important to drink plenty of fluids if you have diarrhoea|.
Mild nausea is quite common, but it's usually easy to control. Your doctor can prescribe anti-sickness drugs| to prevent, or greatly, reduce this.
Sunitinib may make your thyroid work less effectively. Symptoms of an underactive thyroid may include tiredness, weight gain, constipation, aches, feeling cold, dry skin and dry hair. If you have any new symptoms, let your doctor know. You may need a blood test to check your thyroid levels.
This drug may cause bleeding, most often nosebleeds. If you notice any unexplained bleeding, such as bleeding gums, bleeding from your back passage or blood in your stools, contact your doctor straight away. They will advise you about this and any precautions you should take.
Sunitinib may cause heart problems, although this is rare. If you have chest pain, breathlessness| or other symptoms, it may mean that your heart is affected and you should contact your doctor immediately.
Sunitinib may increase your chance of getting a blood clot. If you become breathless or get pain in your limbs, tell your doctor straight away.
Wounds may take longer to heal while you're having treatment with sunitinib.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they're not mentioned above.
Some medicines can interact with sunitinib and may make it less effective. Let your
doctor know about any medicines you're taking, including non-prescribed drugs such as complementary therapies| and herbal drugs|. Avoid taking St John’s Wort, eating grapefruit or drinking grapefruit juice while you're having sunitinib.
It's not advisable to become pregnant or father a child while having sunitinib, as it may harm the developing baby. It’s important to use effective contraception while having this drug, and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether biological therapies can be present in semen or vaginal fluids. To protect your partner it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after treatment.
This should be avoided while taking sunitinib, as the drug may be passed to the baby in breast milk.
It's not yet known how sunitinib may affect fertility|. If you have concerns about this, you can discuss them with your specialist.
This section has been compiled using information from:
Content last reviewed: 1 December 2011
Next planned review: 2013
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© Macmillan Cancer Support 2013
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